Top Tip 5 - Cardiology - Better ECG Traces

Recording and ECG should be easy and indeed it is extremely straightforward with just a couple of simple guidelines depending on the situation.

Placement of electrodes is just one of these essential items that can make all the difference in capturing a high quality diagnostic ECG trace. We hope that the following information helps improve the ease of use of your ECG and the quality of the traces obtained.

Recording an ECG

Connecting an ECG to a patient's skin requires a connector or electrode. These are either adhesive pads (placed on pads of feet and taped, or on a shaved patch on the tops of the feet and taped) or clips that are attached to the limbs.

The single most important part of ECG recording is a good diagnostic quality tracing and this starts with good electrical connectivity to the skin.

Although it may sound trivial, selection and placement of pads and clips can make all the difference to obtaining a high quality ECG.

Alligator clips

Alligator clips are good for once-off ECG capture. This may be in the consultation room or at a specific juncture in workup or treatment.

Clips should be placed on the loose folds of skin at the 'elbows and knees' of the patient.

Alligator clips require a conducting medium – spirit is often adequate – just sufficient enough to wet the clip and hair through to the skin. Spirit, however, evaporates after 5-10 minutes, so this method would not suffice if the ECG recording takes longer than this e.g. anaesthetic monitoring. Therefore if you are intending to monitor a patient's ECG for more than a few minutes, pads are a much better option.

ECG pads

Pads can be taped to the patient's feet and provide a more reliable contact with the skin. Some pads come with electro-conductive gel already applied, but you can easily add additional gel (ECG gel is ideal, but ultrasound gel or KY jelly are cheaper options) to maintain a good contact. Also, pads which are taped on are far less likely to come loose if the patient moves.

Pads are therefore a more appropriate longer-acting alternative and are essential if you intend to leave the ECG connected to your patient for any significant length of time. This will stop you needing to continually re-attach electrodes and allow you to get on with the job of effective monitoring.

To make it simpler for you

We use pads which have off centre connectors which we find far easier to use when connecting and disconnecting leads. If your clinic would be interested in trialling some of these pads, please simply email us at enquiries@sarc.com.au with your clinic details and we will send you a complimentary set of pads to see if you find them useful.

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